Dr. Phyllis Ritchie: Not all vaccines OK for people with HIV

I am 68-year-old gay man, and was recently diagnosed with HIV. I am planning a trip to New York in January. Any health precautions or vaccines I should get prior to my trip? Also, should I get a shingles vaccine? – David, Portland

Hopefully, you are seeing a health care provider, and you are up to date with the routine vaccines recommended for HIV positive patients. Those include: Hepatitis A and B, tetanus/diptheria vaccine, and a pneumococcal vaccine. And, because we're in the flu season, you should have a flu vaccine as well.

The shingles vaccine is not recommended for people with HIV. It is a live virus vaccine, and there is a concern it could actually transmit shingles. There is an AIDS clinical trial looking at giving the shingles vaccine to people with HIV, but presently I would not recommend it for you.

Also, there has been an outbreak of meningococcal meningitis in New York among men who have sex with men. The local health officials there are recommending all men who have sex with men in New York, or men who come in close contact with other gay men in New York get vaccinated against this meningitis. Meningococcal meningitis is spread by contact with spit, mucus or other fluids from the nose or mouth of someone who has the disease.

You should be vaccinated against Hepatitis A and B, tetanus/diptheria, pneumococcus pneumonia, the flu, and meningococcal meningitis (if you plan on having close contact with other gay men in New York). I had to have my ovaries removed two years ago due to severe endometriosis. Should I still have pap smears done? – Sophie, San Francisco

Pap smears are done on a regular basis to help detect evidence of cervical cancer. Cervical cancer is most commonly caused by the human papilloma virus. Even though you had your ovaries removed you still have your uterus and cervix. Therefore you should still see a health care provider for your regular pap smears to check for any evidence of cervical cancer. They also check for any sexually transmitted diseases as well, such as chlamydia and gonorrhea.